Transcervical endometrial cryoablation (ECA) for menorrhagia

OBJECTIVE: To evaluate endometrial cryoablation (ECA) as a treatment for menorrhagia. METHOD: Prospective study of 67 women. ECA uses the Joule Thompson principle of expanding gases. The ECA probe has a channel to inject saline solution into the uterine cavity. The probe is introduced into the uterine cavity, which is distended with 5 ml saline solution. The device is activated for two freeze-thaw cycles. The saline solution forms an ice mold of the uterine cavity which can be observed by ultrasound scan. RESULTS: No surgical or long-term complications were observed. Two-thirds of patients followed up for > 3 months were completely satisfied. CONCLUSIONS: ECA is technically very easy, can be learned quickly, is free of complications and led to improvement of menstrual symptoms in 63% of patients followed up for 3-18 months. The device is virtually maintenance-free and requires only a small initial investment, while running costs are negligible.